What are the responsibilities and job description for the Credentialing Specialist position at Hutchinson Clinic?
Role
Ensure that Clinic Providers are credentialed and appointed with health plans and the Clinic, ASC and other facilities as applicable. Process applications and verify licensing and certifications in a timely manner.
Essential Functions & Responsibilities
Ensure that Clinic Providers are credentialed and appointed with health plans and the Clinic, ASC and other facilities as applicable. Process applications and verify licensing and certifications in a timely manner.
Essential Functions & Responsibilities
- Compile and maintain current and accurate data for all providers.
- Complete provider credentialing and recredentialing applications; monitor applications and follow-up as needed.
- Maintain copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
- Maintain knowledge of current health plan and agency requirements for credentialing providers.
- Set up and maintain provider information in online credentialing databases and system.
- Track license and certification expirations for all providers to ensure timely renewals.
- Ensure clinic addresses are current with health plans, agencies and other entities.
- Process applications for appointment and reappointment of privileges to other healthcare facilities as applicable.
- Track license, DEA, and professional liability expirations for providers.
- Maintain appointment files, and information in credentialing database.
- Audit health plan directories for current and accurate provider information.
- Provides credentialing and privileging verifications.
- Consistently demonstrate good use of time and resources
- Attend training events and maintain competency as required to perform duties.
- Regularly support compliance and accreditation efforts as assigned (e.g., OSHA, HIPAA)
- Be familiar with and consistently implement the organizations mission and all approved policies, protocols, and procedures.
- Serve of committees and work groups upon request.
- Performs other duties that may be assigned from time to time.
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